Medical Mnemonics - Mnemonics or Formulae to memorise medical subjects - Anatomy, Medicine, Pharmacology, Surgery, Gynaecology

DoctorKC’s

Physiology Made Easy
Editor : Saksham Chaudhry

Contents

		Page
01	Homeostasis	3
02	Cell Physiology	7
03	Integumentary System	14
04	Nervous System	16
05	Sensory system	19
06	Muscular System	21
07	Blood Physiology	23
08	Cardiovascular System	29
09	Immunity	33
10	Urinary System	35
11	Respiratory System	36
12	Gastrointestinal System	38
13	Nutrition	41
14	Endocrine System	55
15	Male Reproductive System	56
16	Female Reproductive System	58
17	Pregnancy and Birth	60
18	Genetics and Inheritance	62
19	Development	63
Syllabus - AIIMS		68

Chapter 01 : Homeostasis

Homeostasis is a set of processes by which the body regulates its internal environment. Homeostasis in a general sense refers to stability, balance or equilibrium. Maintaining a stable internal environment requires constant monitoring and adjustments as conditions change. This adjusting of physiological systems within the body is called homeostatic regulation.

Homeostatic regulation involves three parts or mechanisms:-

	*Receptor*
	Control center
	Effector

The receptor receives information about change in the environment.

The control center or integration center receives and processes information from the receptor.

The effector responds to the commands of the control center by either suppressing or boosting the stimulus.

In body control of temperature :-

	Brain is the control center
	Receptor is our body's temperature sensors
	Effector is our blood vessels and sweat glands in our skin

Because the internal and external environment of the body are constantly changing and adjustments must be made continuously to stay around the set point, homeostasis is considered a dynamic equilibrium.

Positive and Negative Feedback

	A change in variable elicits two main types of feedback
	*Negative feedback*: System responds to reverse the direction of change. Reversal of the direction of change contributes to homeostasis.
	*Positive feedback*: System amplifies the change in the variable. This boosting process brings about a change. Hence it does not result in homeostasis.
	Negative feedback is an ongoing process in body systems. Positive feedback is triggered in special situations, like childbirth or accident.

Properties of Homeostatic systems

	Ultra-stable - System is capable of testing which way its variables should be adjusted
	Whole organization (internal, structural, and functional) contributes to maintenance of balance.

Homeostasis altered by :

N	Nutrition
T	Toxins
P	Psychological
P	Physical
G	Genetic/Reproductive:
M	Medical

Homeostatic control

Some	Stimulus– produces a change to a variable (the factor being regulated).
Rotareans	Receptor– detects the change. The receptor monitors the environment and responds to change (stimuli).
Invited	Input– information travels along the (afferent) pathway to the control center. The control center determines the appropriate response and course of action.
On	Output– information sent from the control center travels down the (efferent) pathway to the effector.
Ramp	Response– a response from the effector balances out the original stimulus to maintain homeostasis.

Homoeostatic Controlled systems

C	Core body temperature
B	Blood glucose
P	Plasma ionized calcium
B	Blood partial pressure of oxygen and carbon dioxide
B	Blood oxygen content
A	Arterial blood pressure
E	Extracellular sodium concentration
E	Extracellular potassium concentration
V	Volume of body water
E	Extracellular fluid pH

Physiological Regulation

	Intracellular Regulation
		Control by Local Chemical Factors
		Metabolic auto-regulation of blood flow
		Prostaglandins
	Intrinsic Regulation or autoregulation
	Extrinsic Regulation - control by hormones and/or nerves

Body Systems and their parts

C		Circulation
	H		Heart
	B		Blood vessels
	B		Blood
D		Digestive system
	M			Mouth
	P			Pharynx
	E			Esophagus
	S			Stomach
	S			Small intestine
	L			Large intestine
	S			Salivary glands
	P			Pancreas
	L			Liver
	G			Gallbladder
R		Respiratory system
	N			Nose
	P			Pharynx
	L			Larynx
	T			Trachea
	B			Bronchi
	L			Lungs
U		Urinary system
	K			Kidneys
	U			Ureters
	U			Urinary bladder
	U			Urethra
S		Skeletal system
	B			Bones
	C			Cartilage
	J			Joints
M		Muscle system
				Skeletal muscle
I		Integumentary system
	S			Skin
	H			Hair
	N			Nails
I		Immune system
	L			Leukocytes
	T			Thymus
	B			Bone marrow
	T			Tonsils
	A			Adenoids,
	L			Lymph nodes
	S			Spleen
	A			Appendix
	G			Gut-associated lymphoid tissue
	S			Skin-associated lymphoid tissue
	M			Muscosa associated lymphoid tissue
N		Nervous system
	Binny			Brain
	Sending			Spinal cord
	Paper			Peripheral nervous system.
	Sheets			Special sense organs
E		Endocrine system
	H			Hypothalamus,
	P			Pituitary
	T			Thyroid
	P			Parathyroids
	A			Adrenals
	P			Pancreas
	K			Kidney
	I			Intestine
	H			Heart
	T			Thymus
	P			Pineal
R		Reproductive system
				Male:
	T				Testis
	P				Prostate
	S				Seminal vesicles
	B				Bulbourethral glands
	A			`	Associated ducts
				` Female:
	O				Ovary
	O				Oviduct
	U				Uterus
	V				Vagina
	B				Breast.

Chapter 02 : Cell Physiology

Types of human physiology

Common	1. Cell physiology
Sense	2. Special physiology
Saves	3. Systemic physiology
People	4. Pathophysiology

Levels of Organisation

A	Atom
M	Molecule
M	Macromolecule
O	Organelles
C	Cell
T	Tissue
O	Organ
S	System
H	Human body

Life processes

M	Metabolism
E	Excitability
C	Conductivity
C	Contractility
G	Growth
D	Differentiation
R	Reproduction

Elements in Human body

H	Hydrogen
C	Carbon
N	Nitrogen
O	Oxygen
S	Sodium
M	Magnesium
P	Phosphorus
S	Sulfur
C	Chlorine
P	Potassium
C	Calcium

Characteristics of life

Chief	Cells
Minister	Metabolism
Ganesh	Growth
Rao	Reproduction
Insulted	Irritability
A	Adaptation
Member	Movement

Extracellular fluid

Out of total volume of water in the body, about 2/3 is within cells or intracellular; remaining 1/3 is Extracellular fluid.

The cells take up oxygen and nutrients from the extracellular fluid. Metabolic waste products are also into the same fluid.

Extracellular fluid is divided into 2 components :-

1. Interstitial fluid

2. Circulating blood plasma

The plasma and cellular elements of the blood, mainly red blood cells, constitute Total blood volume.

Extracellular fluid surrounding the cells, which is outside vascular system, is interstitial fluid.

Division of Body weight

Proteins and relared sunstances	18%
Minerals	7%
Fat	15%
Intracellular water	40%
Intravascular extracellular fluid	5%
Interstitial fluid	15%
The total blood volume is about 8% of the body weight.

Measurement of Solutes – Units

Mole	The amount of a chemical substance that contains as many elementary entities, e.g., atoms, molecules, ions, electrons, or photons, as there are atoms in 12 grams of carbon-12 (12C), the isotope of carbon with relative atomic mass 12 by definition. Each mole has 6 × 10 ²³ molecules.
Millimole	1/1,000 of a mole
Micromole	1/1000,000 of a mole
Equivalent	1 mole divided by valency
1M solution	Contains solute 1 mole/litre
1N solution	Contains solute 1 equivalent/litre

Properties of water solvent

	1. Water has a high surface tension
	2. Water has a high heat of vaporization and heat capacity
	3. ater has a high dielectric constant

Electrolytes

	Water is an excellent biological fluid that provides optimal heat transfer and conduction of current.
	Electrolytes (eg, NaCl) are molecules that dissociate in water to their cation (Na + ) and anion (Cl – ) equivalents.
	Because of the net charge on water molecules, these electrolytes tend not to reassociate in water.
	Important electrolytes in physiologyinclude Na⁺ , K⁺ , Ca⁺⁺ , Mg⁺⁺ , Cl^– , and HCO^--- .
	Electrolytes and other charged compounds (eg, proteins) are unevenly distributed in the body fluids.
	These separations play an important role in physiology.

pH and Buffering

	pH is an inverse measure of acidity of a solution; higher the acidity lower the pH
	pH is base 10 logarithm of the reciprocal of hydrogen ion concentration.

The maintenance of a stable hydrogen ion concentration ([H + ]) in body fluids is essential to life. The pH of a solution is defined as the logarithm to the base 10 of the reciprocal of the H + concentration ([H + ]), ie, the negative logarithm of the [H + ]. The pH of water at 25 °C, in which H + and OH – ions are present in equal numbers, is 7.0 (Figure 1–2). For each pH unit less than 7.0, the [H + ] is increased tenfold; for each pH unit above 7.0, it is decreased tenfold. In the plasma of healthy in- dividuals, pH is slightly alkaline, maintained in the narrow range of 7.35 to 7.45. Conversely, gastric fluid pH can be quite acidic (on the order of 2.0) and pancreatic secretions can be quite alkaline (on the order of 8.0). Enzymatic activity and protein structure are frequently sensitive to pH; in any given body or cellular compartment, pH is maintained to allow for maximal enzyme/protein efficiency. Molecules that act as H + donors in solution are considered acids, while those that tend to remove H + from solutions are considered bases. Strong acids (eg, HCl) or bases (eg, NaOH) dissociate completely in water and thus can most change the [H + ] in solution. In physiological compounds, most acids or bases are considered “weak,” that is, they contribute relatively few H + or take away relatively few H + from solution. Body pH is stabilized by the buffering capacity of the body fluids. A buffer is a substance that has the ability to bind or release H + in solution, thus keeping the pH of the solution relatively con- stant despite the addition of considerable quantities of acid or base. Of course there are a number of buffers at work in bio- logical fluids at any given time. All buffer pairs in a homoge- nous solution are in equilibrium with the same [H + ]; this is known as the isohydric principle. One outcome of this prin- ciple is that by assaying a single buffer system, we can under- stand a great deal about all of the biological buffers in that system.

When acids are placed into solution, there is a dissociation of some of the component acid (HA) into its proton (H + ) and free acid (A – ). This is frequently written as an equation:

Tissues in the human body

Earning	Epithelial
Members	Muscle
Never	Nervous
Come	Connective tissues

Cellular adaptation

A		Atrophy
	P		Physiological Atrophy
	E		Endocrine Atrophy
	N		Neuropathic Atrophy
	D		Disuse Atrophy
	N		Nutritional Atrophy
	O		Other Types of Atrophies
				Skeletal muscle atrophy
				Pressure atrophy
				Irradiation atrophy
H		Hypoplasia
H		Hypertrophy
H		Hyperplasia
M		Metaplasia
D		Dysplasia

Specialized Cells of the Human Body

N	Nerve cells (neurons)
E	Epithelial cells
E	Exocrine cells
E	Endocrine cells
B	Blood Cells
		Erythrocytes
		Leucocytes

Membrane proteins

C	Channel proteins
T	Transport proteins
R	Recognition proteins
A	Adhesion proteins
R	Receptor proteins
E	Electron transfer proteins

Membrane Transport

Daily	Diffusion down a concentration gradient
Motion	Movement along electrical gradient
Can	Carrier- Mediated Transport
Fund	Facilitated Diffusion
Visitors	Vesicular Transport

Cytoplasmic organelles

R	Ribosomes
E	Endoplasmic reticulum
		Rough endoplasmic reticulum
		Smooth endoplasmic reticulum
G	Golgi apparatus
L	Lysosomes
P	Peroxisomes
M	Mitochondria
C	Centrosome
C	Centrioles
C	Cytoskeleton
		Microfilaments
		Microtubules

Biological membranes

Passion	1. Plasma membrane (mammals)
Never	2. Nuclear membrane
Occurs	3. Outer mitochondrial membrane
In	4. Inner mitochondrial membrane
Every	5. Endoplasmic reticulum
Man	6. Myelin

Chemical Composition of the Membranes

Let		(a) Lipids
	Few		1. Fatty acids
	Guys		2. Glycerophospholipids
					Phosphatidylethanolamine (cephalin)
					Phosphatidylcholine (Lecithin)
					Phosphatidylserine
	Spend		3. Sphingolipids
					Sphingomyelin
					Cerebrosides
					Gangliosides
	Cents		4. Cholesterol
Public		(b) Proteins
	I		1. Integral membrane proteins (intrinsic membrane proteins)
	Paid		2. Peripheral membrane proteins (extrinsic proteins)
	Them		3. Transmembrane proteins
Come		(c) Carbohydrates
				Concanavalin
				Glycophorin
Daily		(d) Additional Special Features
				(a) Lipid rafts
				(b) Caveolae

Special Structural Characteristics of Red Cells Membranes

	1. Integral proteins
		(a) Glycophorin and
		(b) Band-3-Protein.
	2. Peripheral proteins
		Spectrin
		Actin
		Ankyrin

Transport Systems

India	1. Ion Channels
		a. Ligand gated channels
		b. Voltage gated channels
Is	2. Ionophores
		(a) Mobile ion carriers
		(b) Channel formers
Winning	3. Water Channels (Aquaporins)
Gold	4. Gap Junction

Types of Transport Mechanisms

(a) Passive or simple diffusion
		Water
		Gases
		Pentose sugars
(b) Facilitated diffusion
	D-fructose absorbed from intestine
(c) Active transport
	Protein pumps
	Vesicular transport
			Exocytosis
				(i) Can attach to the cell surface and become peripheral proteins, e.g. antigens.
				(ii) They can become part of extracellular matrix, e.g. collagen and glycosaminoglycans (GAGs)
				(iii) Hormones like insulin, parathormone (PTH) and catecholamines
			Endocytosis
			(i) Phagocytosis
			(ii) Pinocytosis
				(a) Fluid phase pinocytosis
				(b) Receptor mediated absorptive pinocytosis

Factors affecting net diffusion

Can	1. Concentration gradient
Easily	2. Electrical potential
Handle	3. Hydrostatic pressure gradient
Two	4. Temperature
Parties	5. Permeability coefficient

Parts of the Cell

	Cell Membrane
	Chloroplast
	Cytoplasm
	Endoplasmic Reticulum
	Golgi Body/Complex
	Large Vacuole
	Lysosome
	Mitochondria
	Nuclear Envelope
	Nucleolus
	Nucleus
	Ribosome
	Small Vacuole
	Cell Wall

Chapter 03 : Integumentary System

Components

1. Skin

2. Subcutaneous tissue under the skin

3. Hair

4. Nails

5. Assorted glands

Functions of Skin

1. Protection of body from invading microorganisms;

2. Regulation of body temperature through :-

i. Sweating

ii. Vasodilation

iii. Shivering

iv. Piloerection

3. Regulation of ion balances in the blood

4. Stimulation of mast cells alters blood flow and capillary permeability.

5. Synthesis of vitamin D involved in calcium and phosphorus absorption needed for bone growth and repair.

6. Hair on the skin filters the air into the nasal cavity.

7. Pigmentation absorbs some dangerous radiation in sunlight

8. DNA repair enzymes in skin reverse UV damage, thus prevent skin cancer.

Glands

1. Sudoriferous glands – Sweat producing glands

2. Sebaceous glands – Oil producing glands

3. Ceruminous glands – Produce earwax

4. Mammary glands – Produce milk.

Structure of nail

R	Root
N	Nail Bed
N	Nail Plate
E	Eponychium
P	Perionychium
H	Hyponychium

Skin

Skin comprises layers of tissues which guard underlying muscles and organs.

Skin has two layers – Epidermis and dermis.

Epidermis is the outermost layer of our skin. Being tough and resilient, epidermis protects the body from environment.

Epidermis is divided into :-

1. Stratum corneum

2. Stratum lucidum

3. Stratum

4. Stratum granulosum

5. Stratum spinosum

6. Stratum basale.

Chapter 04 : Nervous System

Components of the nervous system

National	Neurons
Defence	Dendrites
Academy	Axons
Gets	Glial cells or Neuroglial cells
Signal	Sensory endings
		1. Exteroreceptors
		2. Propioreceptors
		3. Interoreceptors (visceroreceptors)

Fig 2.1 : Brain – Decision making

Fig 2.1 : Physiology of Brain

Classification of neurons

Two	Tonic or regular spiking
Patients	Phasic or bursting
For	Fast spiking
Treatment	Thin-spike

Nervous impulse – Stages

Do	Depolarization
Rascals	Repolarization
Help	Hyperpolarization
Rascals?	Refractory phase

Phases of the action potential

Road	Resting membrane potential (RMP)
Transport	Threshold potential
Under	Upstroke or rising phase
Open	Overshoot
Rumour	Repolarization phase

CHEMICAL NEUROTRANSMITTER (small, rapidly acting molecules)

A	Acetylcholine (Ach)
D	Dopamine
E	Epinephrine
N	Norepinephrine
S	Serotonin
H	Histamine
G	Glycine
G	Glutamate
A	Aspartate
G	Gamma-aminobutyric acid

Neuropeptides (large, slow-acting molecules)

B	Beta-endorphin
A	ACTH
M	MSH
T	TRH
G	GnRH
S	Somatostatin
V	VIP
C	CCK
G	Gastrin
S	Substance P
N	Neurotensin
L	Leucine
E	Enkephalin
M	Methionine enkephalin
M	Motilin
I	Insulin
G	Glucagons
A	Angiotensin-II
B	Bradykinin
V	Vasopressin
O	Oxytocin
C	Carnosine
B	Bombesin

Whole Muscle Contraction

	Isotonic Contraction
		Concentric contraction
		Eccentric contraction
	Isometric Contraction

ATP provider pathways

Come	1. Creatinine phosphate
On	2. Oxidative phosphorylation
Guys	3. Glycolysis

Chapter 05 : Sensory system

A sense is a physiological method of perception.

Human body has following senses :-

1. Sight (vision)

2. Hearing (audition)

3. Taste (gustation)

4. Smell (olfaction)

5. Touch (somatosensation)

Each sense has a specific nervous system and a dedicated sense organ associated with it.

The sense of taste and sense of smell constitute Chemoreception. Specific receptors for chemical compounds produce an impulse which is sent to the brain and is registered as a certain taste or smell. Taste and Smell are chemical senses because the receptors they contain are sensitive to the chemicals in the food and air.

Taste

Sense of taste is perceived by taste buds and is conveyed via facial nerve (VII cranial), glossopharyngeal nerve (IX cranial), and Vagus nerve (X cranial). Facial nerve carries taste sensations from the anterior 2/3 of the tongue and soft palate. Glossopharyngeal nerve carries taste sensations from the posterior 1/3 of the tongue. A branch of the vagus nerve carries some taste sensations from the back of the oral cavity (pharynx and epiglottis). Information from these cranial nerves is processed by the gustatory system.

Taste buds on the tongue are situated on raised protrusions of the tongue surface called papillae.

Types of papillae

1. Filiform (thread-shape)

2. Fungiform (mushroom-shape)

3. Foliate (leaf-shape)

4. Circumvallate (ringed-circle)

All papillae except the filiform have taste buds on their surface.

Some taste buds act directly by ion channels, others act indirectly.

Types of Taste

1. Salt

2. Sour

3. Bitter

4. Sweet

5. Umami (savory or meaty)

Smell

Smell is perceived in Nasopharynx. Airborne molecules diffuse into solution on moist epithelial surface of nasal passage. Impulse is carried by Olfactory nerve (I cranial). 347 functional smell receptor genes are identified.

Impulse is carried by mitral cells in the olfactory bulb to different parts of olfactory system in the brain.

Disorders of Olfaction

1. Anosmia - Loss of the sense of smell.

2. Phantosmia - Smelling odors that aren't really present.

3. Dysosmia – Altered smell sensation.

Chapter 06 : Muscular System

Muscular system is the system of movement of the body and its organs. Muscles are controlled by nervous system; however, some muscles, like heart muscle, may be autonomous.

Muscle movement may be Voluntary (arms, legs, neck) or Involuntary (heart contraction, peristalsis).

Types of Muscles

1. Smooth muscle – Non-striated involuntary muscles of :-

i. Oesophagus

ii. Stomach

iii. Intestines

iv. Bronchi

v. Uterus

vi. Ureters

vii. Bladder

viii. Blood vessels

2. Cardiac muscle – Striated involuntary muscle of Heart

3. Skeletal muscle – Striated voluntary muscles of :-

i. Head and neck

ii. Trunk

iii. Upper limb

iv. Lower limb

Functions of Skeletal Muscles

1. Body support

2. Bone movement

3. Regulation of body temperature

4. Movement of cardiovascular and lymphatic vessels through contraction

5. Protection of internal organs and helps to stabilize joints

Types of Contractions

1. Isometric contraction – Length of the muscle remains unchanged during contraction. Muscle becomes stiff.

2. Isotonic contraction - Inertia is used to move or work. Muscle uses more energy. Contraction lasts longer than isometric contraction.

3. Twitch - Exciting the nerve to a muscle or by passing electrical stimulus through muscle itself. Some fibers contract quickly while others contract slowly.

Muscle Atrophy - Causes

1. Aging

2. Cerebrovascular accident (stroke)

3. Spinal cord injury

4. Peripheral nerve injury (peripheral neuropathy)

5. Other injury

6. Prolonged immobilization

7. Osteoarthritis

8. Rheumatoid arthritis

9. Prolonged corticosteroid therapy

10. Diabetes (diabetic neuropathy)

11. Burns

12. Poliomyelitis

13. Amyotrophic lateral sclerosis (als or lou gehrig's disease)

14. Guillain-barre syndrome

15. Muscular dystrophy

16. Myotonia congenita

17. Myotonic dystrophy

18. Myopathy

Chapter 07 : Blood Physiology

Important Carrier Proteins of Plasma

	Protein	Materials bound
Arun	Albumin	Fatty acids, bilirubin, many drugs, heme, thyroxine
Arora	Apolipoproteins	Triglycerides, phospholipidsmcholesterol
Has	Haptoglobin	Plasma hemoglobin from lysed red blood cells
Had	Hemopexin	Heme from plasma hemoglobin
Three	Transferrin	Iron
Cardiac	Ceruloplasmin	Copper
Pains	Prealbumin	Thyroxine, vitamin A
Till	Transcortin	Cortisol
Time	Transcoblamin	Cobalamin (vitamin B12)

Major normal variants of hemoglobin

A	Adult hemoglobin
H	Hemoglobin A2 (HbA2)
F	Fetal Hemoglobin (HbF)
G	Glycosylated hemoglobin (HbA1C)
P	Portland
G	Gower I
G	Gower II

Factors stimulating/assisting erythropoiesis

(1) Tissue hypoxia
(2) Erythropoietin (EPO)
(3) Nutritional factors
	Protein and amino acids
	Vitamin B12 and Folic acid
	Other vitamins
		Vitamin B6
		Vitamin B2
		Nicotinic acid (niacin)
		Vitamin C
		Vitamin A
		Vitamin E
	Minerals
		Iron
		Copper
		Cobalt
	*(4) Other hormones*
		Androgens
		Estrogens
		Thyroxine, Cortisol, Growth hormone

ABO system

	Blood type	Agglutinins
	O	Anti-A & Anti-B
	A	Anti-B
	B	Anti-A
	AB	None

ABO Blood Groups: genotype and phenotype

Phenotype	Genotype	Antibody	Forward type patient Cell with		Back type patient Serum with
			Anti-A	Anti-B	A cells	B cells
A	AO, AA	Anti-B	Positive	Positive	Positive	Positive
B	BO, BB	Anti-A	Negative	Negative	Negative	Negative
AB	AB	None	Positive	Positive	Positive	Positive
O	OO	Anti-A, Anti-B	Negative	Negative	Negative	Negative

ABO Red Cells Compatibility

Patient blood type	A	B	AB	O
A	Yes	Yes	Yes	Yes
B	No	No	No	No
O	No	No	No	No
AB	Yes	Yes	Yes	Yes

Blood Component Therapy

W	Whole Blood
P	Packed Red Cells
W	White-cell-poor Red cells
W	Washed Red Cells
F	Frozen Red Cells
P	Platelets
G	Granulocytes
F	Fresh Frozen Plasma
C	Cryoprecipitate
C	Clotting Factor Concentrate
A	Albumin

Elements of the blood

Cell Normal	% of WBC	Average ( cells/ μl)	Range( cells/ μl)
Total WBC		9000	4,000-11,000
Neutrophils	50-70	5400	3000-6000
Eosinophils	1-4	275	150- 300
Basophils		35	0–100
Lymphocytes	20-40	2750	1500-4000
Monocytes	5-8	540	300–600
Erythrocytes
Females		4.8 million
Males		5.4 million
Platelets (thrombocytes)		300,000	200,000–500,000

Plasma components

Water		91.5% of plasma volume
Proteins		7.0%
	Total (S)	6.0-8.0 g/dL
	Albumin (S)	3.5-5.0 g/dL
	Globulin (S)	2.3-3.5 g/dL
	Fibrinogen	0.2-0.4 g/dL
Glucose (fasting)		70-110 mg/dL
Cholesterol (S)		120 –220 mg/dL (P)
Cholesterol esters		60 – 70% of total cholesterol
Lipids, total (S)		450 – 1000 mg/dL
Bilirubin (S)		up to 0.4 mg/dL – conjugated Up to 1.0 mg/dL - conjugated & free
Creatinine (S)		0.6-1.5 mg/dL
Urea nitrogen (BUN)		8-25 mg/dL
Uric acid (S)		Women 2.3-6.6 mg/dL Men 3.6-8.5 mg/dL
Lactic acid (B)		0.5-2.2 meq/L
Pyruvic acid (P)		0-0.11 meq/L
Osmolality (S)		280 –296 mosm/kg of water
pH (B)		7.35-7.45
Bicarbonate		21-27 mEq/L
Calcium (S)		8.5-10.5 mg/dL; 4.3-5.3 mEq/L
Chloride (S)		100-108 mEq/L
Iron (S)		50 – 150 μg/dL (S)
Iodine, Protein –bound		3.5 – 8.μg/dL (S)
Magnesium (S)		1.5 – 2.0 mEq/dL
Phosphatase		1.8-2.6 mEq/dL
Potassium		4.0-4.8 mEq/dL
Sodium (S)		135 – 145 mEq/dL
Sulfate (S)		2.9 – 3.5 mg/dL
Some enzymes:
Amylase (S)		53 – 123 U/L
Phosphates, acid (S)		0-0.8 U/L (prostatic)
Phosphates, alkaline		13-39 U/L (adults)
Transaminase (S)		7 – 27 U/L (SGOT)

Important Carrier Proteins of Plasma

Some humoral mediators (lymphokines) produced by T- lymphocytes

Lymphokine	Regulatory functions
Interleukin-1	Activates resting T cell Hematopoietic growth factor Mediates inflammatory reactions Endogenous pyrogen
Interleukin-2	Growth factor for activated T cells
Interleukin-3	Growth factor for stem cells
Granulocyte-macrophage stimulating factor (GM-CSF)	Promotes growth of hematopoietic cells of different lineage, Activates mature granulocytes& monocytes Promotes neutrophil growth and function
Granulocyte CSF (G-CSF)	Promotes monocyte growth and function
Monocyte CSF (M-CSF)	Growth factor for activated B cells and resting T cell
Interleukin-4	Enhances cytotoxic T cells
Interleukin –6	Induces differentiation of B cells to plasma cell
Interferon (alpha, beta, gamma)	Promotes megakaryocyte and other hematopoietic cell growth
Tumor necrosis factor	Antiviral activity? I NK activity Suppresses hematopoietic cell growth, Direct cytotoxin to some tumors cells, Stimulates production of lymphokines, Activates macrophages, Mediates inflammatory reaction Mediates septic shock

Haemostasis

L	1. Local vasoconstriction
F	2. Formation of a platelet aggregate (platelet aggregation)
F	3. Formation of a blood clot
R	4. Retraction of clot
D	5. Dissolution of clot

Stages of haemostasis

V	1 Vasoconstriction
P	2 Platelet aggregations
B	3 Blood Coagulation
C	4 Clot retraction
D	5 Dissolution of clot (Fibrinolysis)

Coagulation factors

	Common name	Other names
I	Fibrinogen
II	Prothrombin
III	Thromboplastin
IV	Calcium
V	Proaccelerin	Labile factor
VII	Proconvertin	Stable factor
VIII	Antihemophilic factor (AHF)	Antihemophilic globulin Antihemophilic factor A
IX	Plasma thromboplastic component	Christmas factor Antihemophilic factor B
X	Stuart power factor
XI	Plasma thromboplastin antecedent	Antihemophilic factor C
XII	Hageman factor	Glass factor
XIII	Fibrin stabilizing factor	Laki-Lorand factor
HMW-K	High molecular weight kininogen	Fitzgerald factor
Pre-Ka	Prekallikrein	Fletcher factor
Ka	Kallikrein
PL	Platelet phospholipid

Disorders of haemostasis

A. Excessive bleeding
	(a) Vitamin K deficiency
	(b) Hemophilia
		(i) Hemophilia A
		(ii) Hemophilia B
		(iii) Hemophilia C
	(c) Thrombocytopenia
B. Thromboembolic conditions
	(1) Endothelial injury
	(2) Alterations in normal blood flow
	(3) Hypercoagulability
		(a) Inherited
		(b) Inherited

Chapter 08 : Cardiovascular System

Specialized cells or conducting cells

Some	Sinoatarial Node (SA node): Pacemaker of the Heart
Are	Atrial Bundles
Arrogant	Atrioventricular Node
Bosses	Bundle of His

Heart valves

They	Tricuspid
Purchased	Pulmonary
Same	Semilunar
Boots	Bicuspid
And	Aortic
Sandals	Semilunar

Components of the Electrocardiogram

Pretty	P wave
Queen	QRS Complex
Played	PR interval
Some	S-T segment
Trick	T wave

Anatomical location for best hearing the heart sounds

M	Mitral valve	The mitral valve is best heard in the mid-clavicular line of the 4th-5th left intercostals space.
T	Tricuspid valve	The tricuspid valve in the 5th interspace at the left sternal edge.
A	Aortic valve	The aortic valve in the 2nd interspace at the right sternal edge.
P	Pulmonary valve	The pulmonary valve in the 2nd interspace at the left sternal edge.

Heart valves defects

M	Mitral stenosis
M	Mitral insufficiency
A	Aortic stenosis
A	Aortic insufficiency
M	Mitral valve prolapsed
B	Bicuspid and aortic semilunar valves damaged inRheumatic fever

Factors influencing Venous return

Some	Sympathetic Activity
Sikh	Skeletal Muscle Activity
Visitors	Venous Valves
Raised	Respiratory Activity
Concern	Cardiac Suction

Factors influencing cardiac output

Please	Parasympathetic stimulation
Send	Sympathetic stimulation
Empty	Exercise
Tumbler	Training
Pot	Posture (Gravity)

Vessels included in the microcirculation are:

To	Terminal arterioles
My	Meta -arterioles
Aunt	Arterioles
And	Arteriovenous anastomoses
Cute	Capillaries
Parents	Post capillary venules

Factors affecting the blood pressure

A		Age
S		Sleep and exercise
G		Gravity
				a. Direct effect
				b. Indirect effect
E		Emotion and stress
O		Other factors
	Rarely		Respiration
	Visitors		Valsalva maneuver
	Pay		Pregnancy
	Full		Full bladder
	Dues		Distensibility and capacitance of blood vessels

Blood flow through the circulatory system - Seven Sections

H	1. Heart as a pump; elastic arteries as pressure reservoirs
C	2. Cushioning vessels
R	3. Resistance vessels
S	4. Sphincter vessels
E	5. Exchange vessels
S	6. Shunt vessels (Not found in all tissues)
C	7. Capacitance vessels

Circulatory Shock – Classification

H	1. Hypovolemic shock
		(a) Loss of blood
		(b) Loss of water and electrolytes
		(c) Loss of plasma
C	2. Cardiogenic shock
		(a) Myocardial infarction
		(b) Cardiomyopathy
		(c) Inadequate coronary blood flow and ischemia
S	3 Septic shock
N	4. Neurogenic shock
		(a) Deep general anesthesia
		(b) Spinal anesthesia
		(c) Brain damage
A	5. Anaphylactic shock
		(a) Increase in vascular capacity
		(b) Dilatation of arterioles
		(c) Greatly increased capillary permeability

Essential hypertension - Risk factors

F	(1) Family history
A	(2) Advancing age
R	(3) Race
H	(4) High salt intake
O	(5) Obesity
E	(6) Excess alcohol consumption
U	(9) Use of oral contraceptive drugs

Types of hypertension

		I. Essential hypertension
		II. Secondary hypertension
R			Renal
	A			Acute glomerulonephritis
	C			Chronic renal disease
	P			Polycystic disease
	Receives			Renal artery stenosis
	Rare			Renal vasculitis
	Reward			Renin-producing tumors
E			Endocrine
	A			Adrenocortical hyperfunction (Cushing syndrome, primary aldosteronism)
	E			Exogenous hormones (glucocorticoids, estrogen, sympathomimetics)
	P			Pheochromocytoma
	A			Acromegaly
	H			Hypothyroidism (myxedema)
	H			Hyperthyroidism
	P			Pregnancy-induced
C			Cardiovascular
	C			Coarctation of aorta
	P			Polyarteritis
	I			Increased intravascular volume
	I			Increased cardiac output
	R			Rigidity of the aorta
N			Neurologic
	P			Psychogenic
	I			Increased intracranial pressure
	S			Sleep apnea
	A			Acute stress, including surgery

Chapter 09 : Immunity

The immune system is a network of cells, tissues, and organs that work together to defend the body against attacks by foreign invaders. Such invaders are primarily microbes—tiny organisms such as bacteria, parasites, and fungi that can cause infections.

The Immune Barrier – Lines of defence

1. First. Physical and chemical barriers

i. Skin

ii. Stomach acids

iii. Mucus

iv. Tears

v. Vaginal opening

The last three mostly produce lysozyme to destroy harmful incoming pathogens.

2. Second. Non-specific immune responses :-

i. Marcrophages

ii. Neutrophils

iii. Interferons

iv. Complement proteins

v. Nonspecific defenses

a. Fever

b. Inflammatory response

3. Third. Specific immune responses :-

i. T Cells

ii. B Cells

Lymphatic System - Functions

1. Removal of excess fluids, lymph, from body tissues

2. Absorption of fatty acids and subsequent transport of fat, chyle, to the circulatory system

3. Formation of white blood cells (WBCs), and initiation of immunity through the formation of antibodies, lending specific resistance to pathogens.

Lymphatic Organs

	Primary lymphatic organs
		Red bone marrow
		Thymus
	Secondary Lymphatic Organs
		Spleen
		Lymph nodes
		Tonsils
		Peyer’s patches

Leukocytes

Eosinophils

Basophils

Neutrophils

Monocytes

Lymphocytes

Dendritic Cells

Defenses Against Infection

Innate Defense – first line of defense
	Physical or Mechanical barriers
		Skin
		Mucus membranes
		Mucociliary escalator
	Chemical Defenses
		Tears, saliva
		Stomach acids
Non-specific responses to infection - 2nd line of defense
	Inflammatory response
	Complement System
	Interferon in response to viral infection
Adaptive Defense (Specific Defense--third line of defense)
	Lymphocytes
	Plasma cells
	Memory B cells

Chapter 10 : Urinary System

Urinary system filters out excess fluid and other substances from blood stream. Such excess fluid and other substances are passed out in form of Urine.

Urine is produced in kidneys, stored in urinary bladder, and passed out of urethra

Functions of kidneys

1. Regulation of plasma ionic composition

2. Regulation of plasma osmolarity

3. Regulation of plasma volume

4. Regulation of plasma hydrogen ion concentration (pH)

5. Removal of metabolic waste products and foreign substances from the plasma

6. Secretion of Hormones

Chapter 11 : Respiratory System

Functions of Respiratory System

Wealthy	1 Warming and humidification of the inspired air
Father	2. Filtration and cleaning: Mucous secreted by the cells of the conducting zone serves
Died	3. Distribute air to the gas exchange surface of the lung.

Chemoreceptors

Central	Central chemoreceptors
Post	Peripheral chemoreceptors
		Carotid bodies
		Aortic bodies
Office	Other receptors:
		Lung stretch receptors
		Irritant receptors
		J- Receptors (Juxtacapillery receptors)

Hypoxia

Having		(1) Hypoxic hypoxia
	Lady		(a) Low alveolar PO2
	Raj		(b) Reduced ventilation (Hypoventilation)
	Rani		(c) Reduced diffusing capacity
	Lies		(d) Low ventilation-perfusion ratio
	Always		(e) Arteriovenous shunt
A		(2) Anemic hypoxia
Solitary		(3) Stagnant hypoxia
Hotel		(4) Histotoxic hypoxia

Methods of oxygen administration

C	(1) Cannula (intranasal tube)
M	(2) Mask
O	(3) Oxygen tent
Moga	(4) Mechanical ventilator

Disorders of the respiratory system

P	Pulmonary edema
C	Chronic obstructive pulmonary diseases (COPD)
E	Emphysema
C	Chronic bronchitis
A	Asthma

Chapter 12 : Gastrointestinal System

Primary Digestive Organs

	Primary digestive organs
M		i. Mouth
P		ii. Pharynx
E		iii. Esophagus
S		iv. Stomach
S		v. Small intestine
L		vi. Large intestine.
	Accessory Digestive Organs
T		i. Teeth
T		ii. Tongue
S		iii. Salivary glands
E		iv. Exocrine part of pancreas
L		v. Liver
G		vi. Gallbladder

Wall of gastrointestinal tract

M		1. Mucus layer
	Every		i. Epithelial lining
	Lady		ii. Lamina propria
	Married		iii. Muscularis mucosa.
S		2. Submucus layer
M		3. Muscular layer
	In		i. Inner oblique layer
	My		ii. Middle circular layer
	Office		iii. Outer longitudinal layer.
S [Double MS]		4. Serous or fibrous layer.

Salivary glands

	Major glands
Police		1. Parotid glands
Station		2. Submaxillary or submandibular glands
Shimla		3. Sublingual glands.
	Minor glands
Low		1. Lingual Mucus Glands
Lying		2. Lingual Serous Glands
Basti		3. Buccal Glands
Lures		4. Labial Glands
People		5. Palatal Glands

Salivary enzymes

A	Amylase
M	Maltase
L	Lingual lipase
L	Lysozyme
C	Carbonic anhydrase
K	Kallikrein

Salivary – Nonenzyme organic constituents

M		Mucin
A		Albumin
P		Prolin rich proteins
L		Lactoferrin
I		IgA
B		Blood group antigens
F		Free amino acids
N		Nonprotein nitrogen
	U		Urea
	U		Uric
	A		Acid
	C		Creatinine
	X		Xanthine
	H		Hypoxanthine

Salivary – Inorganic constituents

S	Sodium
C	Calcium
P	Potassium
B	Bicarbonate
B	Bromide
C	Chloride
F	Fluoride
P	Phosphate

Hyposalivation

	1. Temporary hyposalivation
Every		i. Emotional conditions like fear.
Female		ii. Fever.
Delivers		iii. Dehydration.
	2. Permanent hyposalivation
Supreme		i. Sialolithiasis (obstruction of salivary duct).
Court		ii. Congenital absence or hypoplasia of salivary glands
Bar		iii. Bell palsy (paralysis of facial nerve).

Parts of stomach

Continued	1. Cardiac region
From	2. Fundus
Back	3. Body or corpus
Page	4. Pyloric region.

Glands of the stomach

Farid	1. Fundic glands or main gastric glands or oxyntic glands
Pay	2. Pyloric glands
Commission	3. Cardiac glands

Cells of fundic glands

C	1. Chief cells or pepsinogen cells
P	2. Parietal cells or oxyntic cells
M	3. Mucus neck cells
Entering	4. Enterochromaffin (EC) cells or Kulchitsky cells
Etawah	5. Enterochromaffin like (ECL) cells.

Enzymes in Gastric juice

Pretty		Pepsin
Good		Gastric lipase
Actor		Additional enzymes
	Get		i. Gelatinase
	Unique		ii. Urase
	Gifts		iii. Gastric amylase
	Ready		iv. Rennin

Chapter 13 : Nutrition

Nutrition requirements

A. Macronutrients

1. Carbohydrates

2. Proteins

3. Fats

B. Micronutrients

1. Vitamins

2. Minerals

Carbohydrates

Made up of three elements

1. Carbon

2. Hydrogen

3. Oxygen

Classification

A. Simple carbohysrates

1. Monosaccharides

i. Glucose

ii. Fructose

iii. Galactose

2. Disaccharides

i. Sucrose

ii. Maltose

iii. Lactose

B. Polysachharides

i. Starch

ii. Fiber

Metabolism

1. In the intestines, polysaccharides are broken into monosaccchorides including glucose.

2. Glucose enters intestinal epithelium and then into the bloodstream.

3. Glucose molecules are taken by glucose transporters and delivered into the cells of the body.

4. In the cells glucose is oxidized for energy.

5. Glucose provides substrates to other metabolic reactions

6. Converted into glycogen for storage.

Sugars with corresponding alcohol

Girl	Glucose	Sorbitol
From	Fructose	Sorbitol and mannitol
Madras	Mannose	Mannitol
Gazing	Glyceraldehyde	Glycerol
Every	Erythrose	Erythritol
Entry	Ribose	Ribitol
Gate	Galactose	Dulci tol

Carbohydrates - Classification

1. Monosaccharides
	Trioses
		Glyceraldehyde
		Dihydroxyacetone
	Tetroses
		Erythrose
		Erythrulose
	Pentoses
		Ribose
		Ribulose
	Hexoses
		Glucose
		Fructose
2. Disaccharide
	Maltose
	Lactose
	Sucrose
	Lactulose
3. Oligosaccharides
4. Polysaccharides (Glycans)
	a. Homopolysaccharides (homoglycans
		Starch
		Glycogen
		Inulin
		Cellulose
		Dextrins
		Dextrans
	b. Heteropolysaccharides (heteroglycans)
		Mucopolysaccharides (glycosaminoglycans)

General Properties

A	Asymmetric carbon
V	Van’t Hoff’s rule of ‘n’
S	Stereoisomerism
D	D-Series and L-Series
O	Optical activity

Properties of Monosaccharides

In	1. Iodocompounds
An	2. Acetylation or ester formation
Open	3. Osazone formation
Indoor	4. Interconversion of sugars
Opera	5. Oxidation to produce sugar acids
		(i) Aldonic acids
		(ii) Saccharic or aldaric acid
		(iii) Uronic acids
Raids	6. Reduction of sugars to form sugar alcohols
Are	7. Action of acids on carbohydrates
Always	8. Action with alkalies
			(a) In dilute alkali
			(b) In conc. alkali
Rare	9. Reducing action of sugars in alkaline solution

Mucopolysaccharides (MPS) - Classification

A		I. Acidic Sulphate free MPS
			1. Hyaluronic Acid
			2. Chondroitin
S		II. Sulphate Containing Acid MPS
	Korean		1. Keratan Sulphate (Kerato Sulphate)
				a. Keratan SO4 I
				b. Keratan SO4 II
	Cheats		2. Chondroitin Sulphates
				a. Chondroitin SO4 A
				b. Chondroitin SO4 B
				c. Chondroitin SO4 C
				d. Chondroitin SO4 D
	Have		3. Heparin
	Hacked		4. Heparitin Sulphate
N		III. Neutral MPS
			a. Blood group substances
			b. Nitrogenous neutral MPS

Naturally occurring thrombin inhibitors in plasma :

A	Antithrombin III
Monkey	2-Macroglobulin
Has	Heparin cofactor II
Attacked	1-Antitrypsin

Functions of Proteoglycans

	1. As a constituent of extracellular matrix or ground substance
	2. Acts as polyanions
	3. Acts as a barrier in tissue
	4. Acts as lubricant in joints
	5. Role in release of hormone
	6. Role in cell migration in embryonic tissues
	7. Role in glomerular filtration
	8. Role as anticoagulant in vitro and in vivo:
	9. Role as a coenzyme
	10. As a receptor of cell
	11. Role in compressibility of cartilages
	12. Role in sclera of eye
	13. Role in corneal transparency

Proteins

Made up of :-

1. Carbon

2. Hydrogen

3. Oxygen

4. Nitrogen

Functions

1. Forms

i. Hormones

ii. Enzymes

iii. Antibodies

2. Fluid and electrolyte regulation

3. pH buffer

4. Transport of nutrients

Amino acids

A. Neutral amino acids
	(a) Aliphatic Amino Acids
		1. Glycine (Gly) or α-amino acetic acid.
		2. Alanine (Ala) or α-amino propionic acid.
		3. Valine (Val) or α-amino-isovaleric acid.
		4. Leucine (Leu) or α-amino-isocaproic acid.
		5. Isoleucine (Ile) or α-amino- β-methyl valeric acid.
		6. Serine (Ser) or α-amino-β-hydroxy propionic acid.
		7. Threonine (Thr) or α-amino-β-hydroxybutyric acid.
	(b) Aromatic Amino Acids
		8. Phenylalanine (Phe) or α-amino-β-phenyl propionic acid.
		9. Tyrosine (Tyr) or parahydroxy phenylalanine
	(c) Heterocyclic Amino Acids
		10. Tryptophan (Trp) or α-amino-β-3-indole propionic acid.
		11. Histidine (His) or α-amino-β-imidazole propionic acid
	(d) Imino Acids
		12. Proline (Pro) or Pyrrolidone-2-carboxylic acid.
		13. Hydroxyproline (Hyp) or 4 hydroxy pyrrolidone-2 carboxylic acid.
	(e) ‘S’ containing amino acids
		14. Cysteine (Cys) or α-amino-β-mercaptopropionic acid.
		15. Methionine (Met) or α-amino-¡-methylthio-h-butyric acid
B. Acidic amino acids
		16. Aspartic acid (Asp) or α-amino succinic acid.
		17. Glutamic Acid (Glu) or α-aminoglutaric acid.
C. Basic amino acids
		18. Arginine (Arg) or α-amino-d-guanidino-n-valeric acid.
		19. Lysine (Lys) or α- å-diamino caproic acid.
		20. Hydroxylysine (Hyl) or α- å-diamino-d-hydroxy-nvaleric acid.

New Amino Acids

	A. Selenocysteine - 21st amino acids
	B. Pyrrolysine - 22nd amino acid

Non-standard Amino Acids

	A. Non-protein amino acid structure s
		β-alanine
		Taurine
		Ornithine and citrulline
		Thyroxine (T4) and Tri-iodo Thyronine (T3)
		¡-aminobutyric acid (GABA)
		β-amino isobutyric acid
		d-aminolaevulinic acid (-ALA)
		S-adenosyl methionine (SAM)
		3, 4-dihydroxy phenyl alanine (DOPA)
	B. D-amino acids
		D-glutamic acid and D-Alanine
		D-amino acids

Nutritional Classification

Express	(a) Essential amino acids – Not synthesized in body
News	(b) Non-essential amino acids – Synthesized in body
Service	(c) Semi-essential amino acids – Synthesized in body in inadequate quantity

Properties of amino acids

I	A. Isomerism
			(a) Stereoisomerism
			(b) Optical Isomerism
A	B. Amphoteric Nature and Isoelectric pH
P	C. Physical Properties:
			Colourless,
			Crystalline
			More soluble in water than in polar solvents.
			High melting point usually more than 200°C
			High dielectric constant
			Large dipole moment
D	D. Chemical Properties
		I. Due to Carboxylic (—COOH) Group
			1. Formation of esters
			2. Reduction to amino alcohol
			3. Formation of amines by decarboxylation
			4. Formation of amides
		II. Properties Due to Amino (–NH2) Group
			1. Salt formation with acids
			2. Formation of acyl derivatives
			3. Oxidation
			4. Reaction with HNO2
			5. Reaction with CO2
			6. Reaction with formaldehyde
			7. Specific colour reactions
		III. Properties of Amino acids Due to Both NH2 and COOH Groups

Classification of proteins - On the basis of shape and size

	Fibrous proteins
		Keratin from hair
		Collagen.
	Globular protein
		Myoglobin,
		Haemoglobin,
		Ribonuclease

Classification of proteins - On the basis of functional properties

D	Defence proteins
		Immunoglobulins involved in defence mechanisms.
C	Contractile proteins:
		Proteins of skeletal muscle involved in muscle contraction and relaxation.
R	Respiratory proteins
		Haemoglobin,
		Myoglobin,
		Cytochromes.
S	Structural proteins:
		Proteins of skin, cartilage, nail.
E	Enzymes: Proteins acting as enzymes.
H	Hormones: Proteins acting as hormones.

Classification of proteins - On the basis of solubility and physical properties

A. Simple Proteins
	1. Protamines
		Salmine
		Sardinine
		cyprinine of fish sperms and testes.
	2. Histones
		Nucleohistones,
		chromosomal nucleoproteins
		globin of haemoglobin.
	3. Albumins
		Plant albumins:
		Legumelin in legumes,
		Leucosin in cereals.
		Animal source:
		Ovalbumin in egg,
		lactalbumin in milk.
	4. Globulins
		Hemopexin
		Transferrin
		Ceruloplasmin
		immunoglobulins.
		ovoglobulin in eggs,
		lactoglobulin in milk
		legumin from legumes.
	5. Gliadins (Prolamines)
		Gliadin of wheat
		hordein of barley.
	6. Glutelins
		Oryzenin of rice
		glutelin of wheat.
	7. Scleroproteins or Albuminoids
		(a) Keratins
		(b) Collagen
		Gelatin
		(c) Elastins
B. Conjugated Proteins
	1. Nucleoproteins
		(i) Deoxyribonucleoproteins
		(ii) Ribonucleoproteins
		Nucleohistone
		b. nucleoprotamine.
	2. Mucoproteins or Mucoids
	3. Glycoproteins
	4. Chromoproteins
		(a) Haemoproteins
		• Haemoglobin
		• Cytochromes
		• Catalase
		• Peroxidase
		(b) Others
		• Flavoprotein
		• Visual purple
	5. Phosphoproteins
	6. Lipoproteins
	7. Metalloproteins
		Ferritin
		Carbonic Anhydrase
		Ceruloplasmin
C. Derived Proteins
	(a) Primary derived proteins
	1. Proteans
		Myosan
		Edestan
		Fibrin
	2. Metaproteins
	3. Coagulated proteins
		cooked meat protein
		cooked egg albumin protein
		alcohol precipitated protein
	(b) Secondary derived proteins
	1. Proteoses or albumoses
	2. Peptones
	3. Peptides
		Dipeptides
		Tripeptides

Biologically Important Peptides

G	Glutathione
C	Carnosine
B	Bradykinin
O	Oxytocin and Vasopressin
A	Angiotensins
G	Gastrin, Secretin and Pancreozymin
C	β-Corticotropin (ACTH), and β MSH
A	Antibiotics
B	Brain Peptides

Normal values of plasma proteins

Total Proteins = 7.0 to 7.5 Gm%
	By Precipitation (Gm %)	By Paper Electrophoresis (% of total proteins)
Albumin	3.7-5.2	50-70
Globulins	1.8-3.6	29.5-54
α₁-globulin	0.1-0.4	2.0-6.0
α₂-globulin	0.4-0.8	5.0-11.0
β-globulin	0.5-1.2	7.0-16.0
¡-globulin	0.7-1.5	11.0-22.0
Fibrinogen	0.2-0.4
A:G ratio = 2.5:1.0 to 1.2:1.0 (Mode : 2:1)

Electrophoretic Pattern in different diseases

*Disease*	*Alb*	*α1-glo*	*α2-glo*	*β-glo*	¡*-glo*
Nephrosis	down		up		down
Chronic liver disease					Up
Infective hepatitis		down	down		Up
Diabetes mellitus			up
Rheumatoid arthritis				up	Up
Systemic lupus erythematosus				up	up
Sarcoidosis			up	up	up
Lymphatic leukaemia					down
Myelogenous and monocytic leukaemia					up
Multiple myeloma	Sharp paraprotein band in β to ¡-region (M band-monoclonal)

Acute Phase Proteins (or Reactants)

C	C-reactive protein (CRP)
H	Haptoglobin (Hp)
A	α1-Antitrypsin
A	α1-Acid glycoprotein (orosomucoid) and
F	Fibrinogen

Proteins excreted in urine may be of following types:-

Send	Serum albumin
A	Albumoses
Paper	Peptones
Boat	Bence-Jones proteins.

Causes of Hypoproteinaemia

Kidney disorders	Massive proteinuria, nephrotic syndrome
Intestinal disorders	Idiopathic exudative enteropathy, enteritis, colitis, fistulae, amyloidosis, polyadenomatosis, Whipple's disease, lymph node metastases
Skin conditions	Burns, Exudative dermatosis
Malnutrition

Fats

Classification of Lipids

S		I. Simple Lipids
			(a) Neutral fats (Triacylglycerol, TG)
			(b) Waxes
	The			True waxes
	Casual			Cholesterol esters
	Visit			Vit A and Vit D esters
C		II. Compound Lipids
	Post		(a) Phospholipids
	Graduate		(b) Glycolipids
	Students		(c) Sulpholipids
	At		(d) Aminolipids (Proteolipids)
	Loss		(e) Lipoproteins
D		III. Derived Lipids
	Feed		(a) Fatty acids
	Me		(b) Monoglycerides (Monoacylglycerol) and Diglycerides
	Apple		(c) Alcohols
M		IV. Miscellaneous
	A			Aliphatic hydrocarbons
	Casual			Carotenoids
	Solitary			Squalene
	Visitor			Vitamins E and K.

TYPES OF FATTY ACIDS

Some	(a) Saturated FA
		Acetic acid CH3COOH
		Propionic acid C2H5COOH
		Butyric acid C3H7COOH
		Caproic acid C5H11COOH
		Palmitic acid C15 H31COOH
		Stearic acid C17 H35COOH
Uunmanned	(b) Unsaturated FA
		(1) Mono unsaturated (Monoethenoid) fatty acids
		(2) Polyunsaturated (Polyethenoid) fatty acids
			Linoleic acid series (18 : 2; 9, 12)
			Linolenic acid series (18 : 3; 9, 12, 15)
			Arachidonic acid series (20 : 4; 5, 8, 11, 14)
Boy	(c) Branched chain FA
Sent	(d) Substituted fatty acids
Cracked	(e) Cyclic fatty acids
		Chaulmoogric acid
		Hydnocarpic acid
Eggs	(f) Eicosanoids

Essential fatty acids (EFA)

Laughing	Linoleic acid
Loud	Linolenic acid
Always	Arachidonic acid

Functions of EFA: (Biomedical Importance)

	Structural elements of tissues
	Structural element of gonads
	Synthesis of prostaglandins and other compounds
	Structural element of mitochondrial membrane
	Serum level of cholesterol
	Effect on clotting time
	Effect on fibrinolytic activity
	Role of EFA in fatty liver
	Role in vision

Deficiency manifestations of EFA

Can	Cessation of growth.
See	Skin lesions: Acanthosis (hypertrophy of prickle
A	Abnormalities of pregnancy and lactation in adult
Fast	Fatty liver accompanied by increased rates of
Kite	Kidney damage.

Unsaturated Alcohols

Principal	(a) Phytol (Phytyl alcohol)
Leaves	(b) Lycophyll
College	(c) Carotene
Secretly	(d) Sphingosine or sphingol

Chemical constants of Fats and Oils

Send	1. Saponification Number
A	2. Acid Number
Pulse	3. Polenske Number
Recorder	4. Reichert-Meissl Number
In	5. Iodine Number
Ambulance	6. Acetyl Number

Types of Phospholipases

	Phospholipase ‘A’
	Phospholipase ‘B’
	Phospholipase ‘C’
	Phospholipase ‘D’

Classification of Phospholipids

Good		Glycerophosphatides
People		Phosphoinositides
Pray		Phosphosphingosides
Often		Other Phospholipids
	P		1. Phosphatidyl Ethanolamine (Cephalins)
	P		2. Phosphatidyl Inositol (Lipositols)
	P		3. Phosphatidyl Serine
	L		4. Lysophosphatides
	P		5. Plasmalogens
	S		6. Sphingomyelins (phosphatidyl sphingosides)
	P		7. Phosphatidic Acid and Phosphatidyl Glycerol
	C		8. Cardiolipin

Functions of Phospholipids

S	Structural
E	Role in enzyme action
B	Role in blood coagulation
L	Role in lipid absorption in intestine
T	Role in transport of lipids from intestines
T	Role in transport of lipids from liver
E	Role in electron transport
L	Lipotropic action of lecithin
I	Ion transport and secretion

GLYCOLIPIDS

C		1. Cerebrosides (glycosphingosides)
	Kanput		Kerasin
	Colleges		Cerebron (Phrenosin)
	Now		Nervon
	Open		Oxynervon
G		2. Gangliosides
			GM-1
			GM-2
			GM-3
			GD-3
S		3. Sulpholipids

Chapter 14 : Endocrine System

Pituitary hormones

F	Follicle stimulating hormone
L	Lutinizing hormone
A	Adrenocorticotropin hormone
G	Growth hormone
T	Thyroid stimulating hormone
O	Oxytocin
P [Flag Top]	Prolactin

Arenal cortex

	Layer	Product
Great	Glomerulosa	Mineralcorticoids
For	Fasiculata	Glucocorticoids
Romance	Reticulata	Sex hormones

Chapter 15 : Male Reproductive System

Structure

	Testes
		Scrotum
		Seminiferous Tubules
		Interstitial Cells (Cells of Leydig)
		Sertoli Cells
		Efferent ductules
	Epididymis
	Ductus Deferens
	Seminal Vesicles
	Ejaculatory Ducts
	Prostate Gland
	Bulbourethral Glands
	Penis
	Urethra

Functions

Hormone Regulation
	Gonadotropin-Releasing Hormone (GnRH)
		Luteinizing Hormone (LH)
		Follicle-Stimulating Hormone (FSH)
	Testosterone
Erection
Ejaculation
Sperm Production

Abnormalities

	Testicular trauma
	Varicocele
	Testicular cancer
	Epididymitis
	Hydrocele
	Inguinal hernia
	Disorders of Penis
		Inflammation of the penis
		Hypospadias
		Phimosis
		Paraphimosis
		Ambiguous genitalia
		Micro penis
		Sexually transmitted diseases
		Erectile dysfunction

Chapter 16 : Female Reproductive System

Female reproductive system comprises :-

	Primary – Two ovaries
		Produce eggs or ova
		Secrete female sex hormones :-
			1. Estrogen
			2. Progesterone
	Accessory sex organs
		A.Genital ducts
Found			Fallopian tubes
Under			Uterus
Cute			Cervix
Vallet			Vagina
		B.- External genitalia
			Labia majora
			Labia minora
			Clitoris

Divisions of Uterus

1. Fundus
2. Body
3. Cervix
	i. Supravaginal portion – communicates with body of uterus through internal os
	ii. Vaginal portion – communicates with vagina through external os

Layers of Uterus

	1. Serous layer or outer layer
	2. Myometrium or middle muscular layer
		i. External myometrium
		ii. Middle myometrium
		iii. Internal myometrium
	3. Endometrium or inner mucus layer

Periods in Female sexual life

	First period – extends from birth to onset of puberty
	Second period – extends from onset of puberty to onset of menopause
	Third period – begins with onset of menopause and lasts rest of the life.

Ovary

	Medula or zona vasculosa
	Cortex
		Glandular structures which represent ovarian follicles.
		Connective tissue cells
		Interstitial cells – clusters of epithelial cells

Chapter 17 : Pregnancy and Birth

Ovulation

Ovulation is the release of egg from the ovaries. In humans, this event occurs when the follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm.

Every month, 15-20 eggs mature inside the ovaries. The ripest egg is released and swept into one of the fallopian tubes. The fallopian tubes connect ovaries to the uterus.

Ovaries may or may not take it in turns to release an egg. Same ovary may release eggs during consecutive months.

Fertilization

The egg survives upto 24 hours after ovulation. If egg comes in contact with sperm within this time, fertilization may occur. Sperm has up to seven days life. It abodes vagina, uterus or fallopian tubes waiting for ovum. The survival time of sperm is termed Fertile window – about 5 days before ovulation and a day after.

Fertile time may be worked out by noting down the length of your menstrual cycle, and then looking out for signs of hormonal and physical changes in the body. The fertility signs show up about five days before ovulation. Ovulation may vary greatly from cycle to cycle, but more often occurs about 14 days before the start of the next menstrual period. Fertile window is likely to be around days 10-15.

Many women have an irregular cycle. If the cycle is irregular, ovulation may occur a week earlier or later during consecutive months.

Fertile signs

1. Changes in cervical mucus

Cervical mucus is the discharge seen on underwear or on toilet tissue while urinating. Changes in cervical mucus may signal instance of fertillization. After period has finished, cervical mucus gradually increases in amount and changes in texture.

Changes in cervical mucus reflect the rising levels of the hormone oestrogen in body. It also shows impending ovulation. Woman is most fertile when mucus becomes clear, slippery and stretchy, like raw egg white. This fertile mucus speeds the sperm on its way up through the uterus. It nourishes and protects the sperm as it travels towards fallopian tubes to meet egg.

2. Aching abdomen

About 20% women can actually feel something happening in their ovaries around ovulation. This can range from mild aching to episodes of pain. Some women have one-sided backache or a tender area. The condition, termed mittelschmerz, may last a few minutes to a few days.

If these sensations are felt at roughly the same time each month, cervical mucus should be checked. Ovulatory ache may be a useful guide to instance of fertilization.

3. Increased libido

Woman Feels sexy, flirty and more sociable may all be signs that woman is at her most fertile. Woman may notice a peak in sexual desire at such time. She may find her husband a little more possessive and attentive as a result.

4. Looking and feeling great

Woman feels more physically attractive as she nears ovulation. She may be more attractive to others, too. Without realising it, she may choose flattering clothes.

5. Scent of a woman

Woman smells good at this time. Her body odour is more pleasant and desirable around the time she is fertile. She may think that nobody knows she is ovulating, but those natural scents may be quite revealing.

Chapter 18 : Genetics and Inheritance

Genetics is the science of the way traits are passed from parent to offspring. For all forms of life, continuity of the species depends upon the genetic code being passed from parent to offspring. Evolution by natural selection is dependent on traits being heritable.

Genetics is very important in human physiology because all attributes of the human body are affected by a person’s genetic code. It can be as simple as eye color, height, or hair color. Or it can be as complex as how well your liver processes toxins, whether you will be prone to heart disease or breast cancer, and whether you will be color blind. Defects in the genetic code can be tragic. For example: Down Syndrome, Turner Syndrome, and Klinefelter's Syndrome are diseases caused by chromosomal abnormalities. Cystic fibrosis is caused by a single change in the genetic sequence.

Each cell in the body contains 23 pairs of chromosomes - 22 pairs of autosomal chromosomes and a pair of sex chromosomes. One chromosome from each pair is inherited from mother and one is inherited from father. The chromosomes contain the genes inherited from parents. The different forms of genes for eye colour are caused by mutations in the DNA code.

Deoxyribonucleic acid (DNA) is the macromolecule that stores the information necessary to build structual and functional cellular components. It also provides the basis for inheritance when DNA is passed from parent to offspring. The union of these concepts about DNA allows us to devise a working definition of a gene. A gene is a segment of DNA that codes for the synthesis of a protein and acts as a unit of inheritance that can be transmitted from generation to generation. The external appearance (phenotype) of an organism is determined to a large extent by the genes it inherits (genotype). Thus, one can begin to see how variation at the DNA level can cause variation at the level of the entire organism. These concepts form the basis of genetics and evolutionary theory.

A gene is made up of short sections of DNA which are contained on a chromosome within the nucleus of a cell. Genes control the development and function of all organs and all working systems in the body. A gene has a certain influence on how the cell works; the same gene in many different cells determines a certain physical or biochemical feature of the whole body (e.g. eye color or reproductive functions). All human cells hold approximately 30,000 different genes.

Heredity and variations form the basis of genetics. Humans apply knowledge of genetics in prehistory with the domestication and breeding of plants and animals. In modern research, genetics provide important tools for the investigation of the function of a particular gene, e.g., analysis of genetic interactions. Within organisms, genetic information is generally carried in chromosomes, where it is represented in the chemical structure of particular DNA molecules.

Chapter 19 : Development

Stages of development

	1. Infancy: This period extends from birth to 18 months of age
	2. Early childhood: This stage ranges from 18 months to 3 years
	3. Middle childhood: This stage extends from 3-5 years
	4. Late childhood
	5. Adolescence
	6. Early adulthood
	7. Mature adulthood
	8. Old age

Milestones by age

1–4 months
	Physical
		Head and chest circumference are nearly equal to the part of the abdomen.
		Head circumference increases approximately 2 cm per month until two months, then increases 1.5 cm per month until four months.
		Increases are an important indication of continued brain growth.
		Continues to breathe using abdominal muscles.
		Posterior fontanelle.
		Anterior fontanelle.
		Skin remains sensitive and easily irritated.
		Legs may appear slightly bowed.
		Cries with tears.
		Gums are red.
		Eyes begin moving together in unison (binocular vision).
		Responds to and thrives on warm, sensitive physical contact and care.[8]
		Expresses discomfort, hunger or thirst.
		Has very poor vision. The infant has trouble focusing on objects and could barely make out images with its eyes.
	Motor development
		Rooting and sucking reflexes are well developed.
		Swallowing reflex and tongue movements are immature; inability to move food to the back of the mouth.
		Grasp reflex.
		Landau reflex appears near the middle of this period; when baby is held in a prone (face down) position, the head is held upright and legs are fully extended.
		Grasps with entire hand; strength insufficient to hold items. Holds hands in an open or semi-open position.
		Movements are large and jerky.
		Raises head and upper body on arms when in a prone position.
		Turns head side to side when in a supine (face up) position; cannot hold head up and line with the body.
		Upper body parts are more active: clasps hands above face, waves arms about, reaches for objects.
		According to Sigmund Freud, the infant is in the oral fixation stage. The oral fixation stage is when the infant begins to root and suck.
4–8 months[10][edit]
	Physical
		Head and chest circumferences are basically equal.
		Head circumference increases approximately 1 cm per month until six to seven months, then 0.5 cm per month; head circumference should continue to increase steadily, indicating healthy, ongoing brain growth.
		Posterior fontanelle closing or fully closed.
		Anterior fontanelle.
		Breathing is abdominal; respiration rate depending on activity; rate and patterns vary from infant to infant.
		Teeth may begin to appear, with upper and lower incisors coming in first. Gums may become red and swollen, accompanied by increased drooling, chewing, biting, and mouthing of objects.
		Legs may appear bowed; bowing gradually disappears as infant grows older.
		Fat rolls ("Baby Fat") appear on thighs, upper arms, and neck.
		True eye colour is established.
	Motor development
		Reflexive behaviors are changing:
		Blinking reflex is well established
		Sucking reflex becomes voluntary
		Moro reflex disappears
		When lowered suddenly, infant throws out arms as a protective measure.
		Swallowing reflex appears and allows infant to move solid foods from front of mouth to the back for swallowing.
		Picks up objects using finger and thumb (pincer grip).
		Reaches for objects with both arms simultaneously; later reaches with one hand or the other.
		Transfers objects from one hand to the other; grasps object using entire hand (palmar grasp).
		Handles, shakes, and pounds objects; puts everything in mouth.
		Able to hold bottle.
		Sits alone without support, holding head erect, back straightened, and arms propped forward for support
		Pulls self into a crawling position by raising up on arms and drawing knees up beneath the body; rocks back and forth, but generally does not move forward.
		Lifts head when placed on back.
		Can roll over from back or stomach position.
		May accidentally begin scooting backwards when placed on stomach; soon will begin to crawl forward.
		Looks for fallen objects by 7 months
		Plays ‘peek-a-boo’ games
		Cannot understand "no" or "danger"
8–12 months
	Physical
		Respiration rates vary with activity
		Environmental conditions, weather, activity, and clothing still affect variations in body temperature.
		Head and chest circumference remain equal.
		Anterior fontanelle begins to close.
		Continues to use abdominal muscles for breathing.
		More teeth appear, often in the order of two lower incisors then two upper incisors followed by four more incisors and two lower molars but some babies may still be waiting for their first.
		Arm and hands are more developed than feet and legs (cephalocaudal development); hands appear large in proportion to other body parts.
		Legs may continue to appear bowed.
		"Baby Fat" continues to appear on thighs, upper arms and neck.
		Feet appear flat as arch has not yet fully developed.
		Both eyes work in unison (true binocular coordination).
		Can see distant objects (4 to 6 m or 13 to 20 ft away) and points at them.

Syllabus – All India Institute of Medical Sciences

OBJECTIVES

Knowledge

At the end of the course the student will be able to:

�explain the normal functioning of all the organ systems of the body and their interactions.

�narrate the contribution of each organ system to the maintenance of homeostasis.

�elucidate the physiological aspects of normal growth and development.

�describe the physiological response and adaptations to environmental stresses.

�list the physiological principles underlying pathogenesis and treatment of disease.

Skills

At the end of the course the student will be able to:

perform experiments designed either primarily for the study of physiological phenomena or for assessment of function.

analyse and interpret experimental/investigative data critically.

distinguish between normal and abnormal data derived as a result of tests which he/she has performed and observed in the laboratory.

COURSE CONTENT

Lectures

General Physiology

Total Marks	300
Internal Assessment	150
Professional Examination	150

			Theory	Practical &Viva
I Semester	Mid Term	50	25	25
	End Term	50	25	25
II Semester	Mid Term	50	25	25
*Professional Examination*
Theory	Paper I	37.5 Marks
	Paper II	37.5 Marks
Practicals		60 Marks
Viva		15 Marks
Paper I